A validation trial of Coeliac.Mindovergut.com: A brief psychological online resilience program for individuals living with coeliac disease and low-to-moderate psychological distress.

The online Coeliac.Mindovergut.com intervention program is based on a combination of Stress Management (SM), CBT, and Acceptance and Commitment Therapy (ACT). SM strategies (such as relaxed breathing) will be utilised to reduce stress and the physiological impact that stress has on the body (e.g., increased muscle tension around the gastrointestinal tract). CBT strategies such as cognitive flexibility (identify and challenge unhelpful thinking patterns that promote stress and coeliac disease symptoms e.g., ‘My coeliac disease is getting worse’) and exposure work (a planned activity where individuals confront a situation which they currently avoid due to unwanted distress). ACT strategies (e.g., Mindfulness and cognitive defusion) aim to change the negative cycle of distress associated with illness. A summary of the modules and their focus of target around coeliac-related processes are provide below: Module 1: Stress management & moving towards your vision for the future – Stress management and setting goals based on your values; Targets: Hypervigilance/visceral sensitivity, perceived lack of control regarding coeliac disease, stress and psychological distress, and Identifying with illness Module 2: How you think impacts on how you feel – Mindfulness and acceptance, and cognitive defusion; Targets: Catastrophizing and ruminating about symptoms, perceived lack of control regarding coeliac disease, hypervigilance/visceral sensitivity, and stress and psychological distress Module 3: How you think impacts on how you feel - Cognitive flexibility; Targets: Catastrophizing and ruminating about symptoms, perceived lack of control regarding coeliac disease, hypervigilance/visceral sensitivity, and stress and psychological distress Module 4: How you act can impact on how you think and feel - Exposure work; Targets: Avoidance, safely behaviours; Module 5: Review and overcoming setbacks (OPTIONAL); Targets: Building gains, overcoming setbacks, other resources Each of the modules will primarily consist of the principal investigator providing an oral commentary on module content. In addition, participants will be provided with handouts and audio files (relaxation tracks), see supplementary document for intervention content. All intervention content, including handouts and audio files were specifically developed for the Mindovergut resilience program. Each module (1 per week) will take approximately 45 minutes to complete and homework activities taking around 20-40 minutes per day. All participants are offered to access module 5 after completing the postintervention questionnaire. Participants self-select if they wish to access the final module.